Adapting Marital Therapy in Older Adults With Depression
试验速览
- 阶段
- 1 期
- 状态
- 已完成
- 入组人数
- 42
- 试验地点
- 1
- 主要终点
- Hamilton Depression Rating Scale (HDRS)
研究概览
简要总结
The primary goal of this study is to develop and test a depression-specific marital therapy tailored for use with older adult populations.
详细描述
Major depression has been associated with many individual and interpersonal problems in later life, including inadequate social support, marital distress, spousal depression, poor physical health, and higher rates of mortality. Marital therapy has shown promise as a treatment for depression and coexisting marital distress in younger cohorts, and there is a robust association between social support and depressive symptoms in older adults. The combination of couple therapy and antidepressant medication may provide an ideal treatment for older adults by targeting interpersonal and biochemical aspects of depression.
Couples interested in this study will complete an initial assessment with study personnel. In Phase I, eligible couples will receive weekly marital therapy and the depressed partner will receive medication management with a study doctor for 6 months. In Phase II, couples will be randomly assigned to either the combination treatment (marital therapy plus medication management) or medication management alone for 6 months. At the end of the treatment phase, a thorough assessment will be completed. A follow-up assessment will be completed 6 months after completion of treatment.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Treatment
- 盲法
- Single (Outcomes Assessor)
入排标准
- 年龄范围
- 60 Years 至 —（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •One partner must receive a clinical diagnosis of major depressive disorder based upon our assessment
- •Couples must be living together
- •Either partner must report marital distress or tension
- •Willing to take antidepressant medication and participate in weekly marital therapy and assessments
- •The depressed partner cannot be involved in any other psychosocial treatment
- •Score above 24 on the Mini Mental Status Exam
排除标准
- •Both partners meet diagnostic criteria for major depressive disorder based on our evaluation
- •Coexisting bipolar or psychotic disorder
- •Evidence of a primary substance abuse or dependence disorder
- •Current ECT treatment
- •Evidence of active and severe domestic violence
研究组 & 干预措施
Combination
Medication management with a study doctor every other week plus weekly marital therapy.
干预措施: Weekly marital therapy (Behavioral)
结局指标
主要结局
Hamilton Depression Rating Scale (HDRS)
时间窗: pre-treatment, monthly, post-treatment, 6 month follow-up
The HDRS is a semi-structured interview administered by a trained independent evaluator, and used for rating the severity of depressive symptoms. Scores range from 0 to 50, with higher scores indicating greater severity of depression.
Dyadic Adjustment Scale (DAS)
时间窗: pre-treatment, monthly, post-treatment, 6 month follow-up
The DAS is a self-report measure of marital adjustment that includes questions about agreement on lifestyle and household decisions, level of conflict, level of cooperation, and affection. Scores range from 0 to 151, with higher scores representing better relationship functioning.
次要结局
- Frequency & Acceptability of Partner Behavior(Pre-treatment, post-treatment, 6 month follow-up)
- Conflict Tactics Scale(pre-treatment, post-treatment, 6 month follow-up)
- SCID Mood Disorders(pre-treatment, post-treatment, 6 month follow-up)
- Personal Assessment of Intimacy in Relationships(pre-treatment, post-treatment, 6 month-followup)
- Beck Anxiety Inventory(pre-treatment, post-treatment, 6 month follow-up)